Sometimes I just blurt out what I think. And don’t tell me to take a deep breath, cool down and come back to it later. I know I should do that, but for some reason that doesn’t always work either.
I look back on it now and know that it is typical disinhibited behavior. That’s a word I learned while working on a master’s degree in Communication Science and Disorders. It’s gotten to be a very bad habit too. For so many years my reaction to other people’s reaction was “What’s the matter with them?” I didn’t realize it was me who had the poor communication skills.
Unfortunately, I got nailed for disinhibited behavior again today during a conversation on Facebook. We were talking about one of my earlier blog post, Communication after Brain Injury, where I was pontificating about communication problems that us folks with brain injury have. In the blog, I was describing how another brain-injured speech-language pathologist and I were thinking “what’s the matter with them” SLPs who can’t communicate with us?
In responses on Facebook, one reader posted a comment about how difficult it is for SLPs to change their communication style depending upon the patient’s needs when seeing one person after another – young, old, different speech or language disorders, etc. Okay.
The next poster gave some good advice; “When seeing a patient with TBI for the first time, it is important to get as much info regarding the nature, severity and location of the injury prior to being seen. Also important is to get an idea of what the person was like before the injury. Personality traits & emotions are often intensified post TBI.”
She continued with a comment that blew me away: “Also, ALWAYS have an easy escape out in case you need to leave quickly. Pts. with a TBI can often be volatile.”
Volatile? Escape route? What the heck? I responded, “As a person with brain injury, I had to ‘walk away’ from this comment and cool down for a few days before returning with my thoughts about your last 2 sentences. I found it particularly offensive because I know that persons with brain injury are not ‘often’ volatile.”
Taking a few days to cool off didn’t help, because in the next sentence, I started to get personal and, well, volatile.
“As a communication expert, you should know that anger is a symptom and a form of communication. If you find that patients with TBI are ‘often’ volatile, I would suggest that you examine what you are doing to provoke the individual to react strongly to what you are asking him or her to do. The ‘volatile behavior’ that you see is frequently seen in individuals with traumatic brain injuries which affect the frontal lobe, with problems including disinhibition, reduced ability to modulate affect, poor frustration tolerance, impatience, and great susceptibility to being stressed by multiple stimulation.”
Now there is some truth to that, but my communication was less than tactful and getting worse.
“It is your job to help the patient understand his impaired communication skills. If you frustrate patients to the point that you have to plan your escape, I suggest you examine your biases. When you express them non-verbally you dehumanize your patients. Learn to communicate with your patients as people and equals, as human beings with agency.”
Yeah. Geez, Louise. The poster sent a comment back saying that everyone is entitled to their opinions, but that communication of the same could be accomplished in a more respectful manner.
It brought me up short. Why, yes, I was a little rude, wasn’t I? I had exhibited my brain-injured communication dysfunction. I shouldn’t have gotten so worked up and personal. Whether there was some truth to what I said or not, that isn’t the point. The point is that my communication skills were not skillful.
Before I understood my brain injury symptoms, something like this would have sent me into quite a tailspin because I would know I was right, albeit opinionated! Now that I do understand that my communication skills are impaired by my inability to focus and propensity to “flood,” all I can say afterwards is that I’m sorry. I’ll get to work on a strategy to prevent this from happening again. But that doesn’t mean that it won’t happen again. And again. Ugh.
In the end, the page moderator said something to soothe me: “You both make good points. I hear you both.”
Thanks. It’s not easy being brain-injured, but I swear I’m working hard at getting better. It seems to be a never-ending process. Well actually, I know it is.